Polysubstance abuse and traumatic brain injury: Quantitative magnetic resonance imaging and neuropsychological outcome in older adolescents and young adults

Abstract

Few studies have examined the consequences of alcohol and drug abuse on TBI though they commonly co-occur. Both TBI and substance abuse independently result in neuropathological changes in the brain such as ventricular enlargement and cortical atrophy, thus it is reasonable to hypothesize that the combination of the two would result in more significant cerebral damage. In this study, 3 groups of patients-traumatically brain injured (TBI) with substance abuse~N 5 19), TBI without substance abuse~N 5 19), and substance abuse with no TBI~N 5 16)-were compared with normal controls~N 5 20) on several quantitative MRI (QMRI) measures. Since TBI most frequently occurs in older adolescents and young men, we examined only male participants between 16 and 30 years of age. Comparing young substance abusers to controls resulted in no QMRI differences. When controlling for head injury severity, the effects of substance abuse in combination with TBI resulted in greater atrophic changes than seen in any other group. TBI and substance abuse patients' neuropsychological test performances also were examined, and no differences were found among patient groups on any measures. These findings have implications for the deleterious interaction of substance abuse combining with TBI to result in greater neuropathological changes that can be detected by QMRI techniques. (JINS, 1999, 5, 593-608.)

Effects of hypoxia on the brain: Neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea

“…Since VBR takes into account total brain volume there is no need to adjust for brain size. VBR has been shown to be a measure of generalized atrophy (i.e., whole brain volume loss; Barker et al, 1999;Bigler et al, 2000;Blatter et al, 1997;Gale et al, 1995). VBR was defined as abnormal if it was at least 1.5 standard deviations above the mean compared to age and sex stratified normative data.…”

Early outcome in patients with traumatic brain injury, pre-injury alcohol abuse and intoxication at time of injury

“…Numerous imaging studies have demonstrated changes in brain structure related to alcohol abuse [8,9]. Mild-to-moderate neuropsychological deficits have also been found in a large number of studies, with alcohol abusers performing significantly lower than non-drinkers on formal neuropsychological testing [8,10].…”

Age and functioning after mild traumatic brain injury: the acute picture

“…Thirdly, the younger group self-reported more use of substances, although again this was not significantly different between groups. Substance abuse is associated with TBI in the younger population [30,31], and is generally thought to herald a Age and functioning after mild TBI 861 [32] found that blood alcohol level at hospital admission predicted poorer verbal memory and visuospatial functioning following TBI, other studies have not found a relationship between neuropsychological impairment and the presence [33] or degree of substance abuse [34] in patients with TBI. Nonetheless, the self-report of dysfunction and distress may be somewhat exaggerated in the younger group on the basis of substance-mediated problems, thus artificially raising the actual symptoms endorsed in the younger group.…”